NHS staff must receive a pay increase of at least 4%, independent experts advised, putting health care workers on a collision course with ministers who set a fixed cap of 3%.
The Pay Review Board (PRB) will recommend that NHS staff be increased this year by 4% to 5%, the Guardian understands, despite warnings from the government that implementing such advice would break the bank.
And health unions have warned that even lifting this order will do little to placate nurses, midwives and other staff – and they are struggling to avert the possibility of a strike across the NHS.
They have stressed that NHS workers are struggling with the rising cost of energy, petrol, food and other basic commodities, which has left some forced to use food banks.
Unions are seeking increases at least matching inflation, which is 9.1%, the highest in 40 years, although the Royal College of Nursing (RCN) is seeking a five percentage point higher – 14%.
For every extra 1% that NHS staff in England receive, it will cost NHS England around £700m a year, the Department of Health and Social Care (DHSC) calculates.
Pat Cullen, the RCN’s general secretary, claimed an offer of a 4% payment would be an “insult”, driving down wages in real terms for nurses and exacerbating shortages in the NHS.
“A 4% salary increase would be an insult, making an experienced nurse worse off at more than £1,400 a year. She said ministers had a very important choice to make – offering a raise above inflation to the nursing profession or continuing the current mass exodus of staff, endangering the profession. More patients at risk.
Health experts and employee groups widely expected the PRB to recommend a 3% increase for 2022/23, the same amount it got last year, when they submit their detailed written advice to the DHSC.
The Guardian was told that while it was initially supposed to grow 3% again, the independent group of eight experts revised its thinking and settled on a figure over 4% or over 4%.
Its decision to recommend at least 4% will increase pressure on ministers to drop their insistence, outlined in their written testimony to the PRB in February, that 3% is the maximum the government can offer to employees this year. She said anything more than 3% would not be “affordable”, given the NHS’ need to focus spending on treating the huge number of people waiting for hospital treatment. “Fiscal constraints are needed on wages,” she told PRB.
Unison also emphasized that 4% would not avoid the increased pressure of an industrial strike. “Anything less than inflation would be a wage cut,” said Sarah Gorton, head of the union’s health department.
But 4% is less than half the current cost of living. Such a low award could also see dissatisfied health workers being asked by their unions to act.”
The Policy Review Office (PRB) is advising the Prime Minister, the DHSC, the Cabinet Secretary and three delegated departments on pay increases for the 1.5 million NHS staff across the UK covered by the long-standing Change Agenda Agreement – all staff except doctors and dentists.
He takes into account a range of factors when forming his view, including the need to recruit and retain staff as well as the budgets available to health departments in the four countries.
However, this week the Department of Homeland Security did not repeat its earlier position that 3% was the most it could afford, leaving open the possibility that it would support a higher number.
A DHSC spokesperson said: “NHS staff received a 3% pay increase last year which has increased nurses’ salaries by an average of £1,000 despite a public sector wage freeze, and we are giving NHS workers another pay raise this year.
“No decisions have been made and we will carefully consider recommendations from independent wage review bodies.”
If the government decides to drop its 3% scheme and agree to a higher payment offer to try to avoid strikes, it can do so – but leave NHS England to pay the additional costs involved from within its budget. It did just that last year, when it only agreed to a 2.1% increase.
Sajid Javid, the health minister, insisted twice this month that the NHS “doesn’t need more money”. The US Department of Homeland Security recently awarded the NHS an additional £1.5 billion to help cover the cost of significant price increases this year, especially energy.